This project will continue a 30 year surveillance effort assessing the levels and patterns of substance use among American Indian adolescents attending reservation schools. Each year of the five year project a representative sample of 1500 Indian youth living on reservations will be given a comprehensive drug use survey in their school classroom. In addition, the survey will contain questions regarding violence, victimization and delinquent behaviors; which will continue surveillance of these behaviors over a 10-year period. The purposes of the surveillance work are to observe changes over time, to accurately describe these domains, to provide insight into the nature of drug use, violence and victimization and to inform the efforts of those designing and evaluating intervention efforts. Due to the continuing high rates of marijuana and drunkenness among American Indian youth in many reservation communities, reaching levels that are normative or near normative, extended survey data will be obtained on the attitudes and perceived norms for these behaviors. Substance-specific variables for marijuana, getting drunk (normative behaviors) and inhalant use (non-normative) will be obtained from reservation schools and from a random sample of non-Indian youth living in rural areas. New items regarding attitudes toward marijuana will be included in the survey and the Theory of Normative Social Behavior will be used to compare the attitudes between Indian and non-Indian youth. Hierarchical linear models will be used to assess both the individual and school-level effects of the perceived normative environment for these three types of substance use (alcohol, inhalants and marijuana) which represent varying levels of normative and non-normative use. In addition to the effects of the perceived normative environment, the role of cultural identification will also be examined as a moderating or mediating variable. A final goal of the project is to develop a series of recommendations, based on project findings, for the design of drug, alcohol and violence prevention programs that will be effective specifically for American Indian youth. Schools will be provided with extensive feedback on their survey results which is intended to raise community awareness of drug use levels and patterns, to obtain funding for prevention activities and to evaluate the effectiveness of prevention interventions that have been implemented in the community. PUBLIC HEALTH RELEVANCE: This project will continue 30 years of surveillance of drug use among American Indian youth. These data have been used by various agencies to create policies for reducing substance use for these youth. Importantly, the tribes involved have used the data to raise awareness of the levels of drug use in their communities, to evaluate prevention interventions and as a statement of need when applying for prevention funding.